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the dangers of milk. When enforced by proper sanitary inspection of the dairies and their products, such ordinances have produced marked improvement. Nevertheless, instances of such thorough measures as the suppression of the sale of the milk of tubercular cows are rare indeed, even in the smallest municipalities.

The great difficulty in the way of securing a perfectly satisfactory milk supply lies in the expense of production. Dairymen are unable to comply with modern sanitary requirements for milk production at the ordinary price, and the general public is unwilling to pay an advanced price. In general the machinery of our State and municipal health departments has proved inadequate to the task of enforcing the production of milk of such a quality suitable for a physician to recommend for infant feeding.

Recognizing these conditions, Dr. Henry L. Coit, of Newark, N. J., in 1893, originated the medical milk commission idea. He brought about the appointment, by the Essex County Medical Society, of a milk commission. This body drew up a set of rules for the production of milk of the highest sanitary quality and induced a dairyman to undertake the production of milk in accordance with them. The commission is informed of the conditions at the dairy and of the character of the product, by reports from its four experts-veterinarian, chemist, bacteriologist, and medical examiner of the milkers. The dairyman was compensated for the expense of the inspections and other items by the increased price obtained for his product. He of course relies upon the recommendation of the milk commission for his trade at the comparatively high pricetwelve to fifteen cents a quart. The arrangement enables the physician to prescribe the "certified milk" for his patients with confidence that it is produced under conditions necessary to insure its being a safe food. The medical milk commission scheme for providing clean milk has proven a success and commissions patterned on the general lines of the parent one have sprung into existence. At present twenty-two are to be found scattered through the country from Massachusetts to California. The movement in the State of California is represented by the Oakland Home Club Milk Commission and that of the San Francisco County Medical Society.

On June 3, 1907, a conference of delegates from all the milk commissions in existence was held. in Atlantic City. In addition to those officially connected with milk commissions there were present others who are prominently identified with the campaign for better milk. A national organization of milk commissions was accomplished and reports of the work of the various commissions were made by the delegates. Action was taken to define matters relating to the organization, scope of milk commissions, and to unify the requirements to which dairymen must comply. The one meeting of the organization has been of immense benefit to the pure milk movement by unifying the various agencies concerned.

The facts brought to light at the Atlantic City meeting give assurance that the milk commission movement has passed out of the experimental stage into an era of rapid expansion. Enough has been done to encourage more county medical societies to appoint medical milk commissions and to impress dairymen with the financial practicability of producing pure milk.

DR. ARCHIBALD R. WARD, Director of State Hygienic Laboratory.

6.

Vol. 3.

MONTHLY BULLETIN.

Entered as second-class matter August 15, 1905, at the post office at
Sacramento, California, under the Act of Congress of July 16, 1894.

SACRAMENTO, JUNE, 1907.

STATE BOARD OF HEALTH.

MARTIN REGENSBURGER, M.D., President,
WALLACE A BRIGGS, M.D., Vice-President,

F. K. AINSWORTH, M.D.
San Francisco A. C. HART, M.D.
O. STANSBURY, M.D..
Sacramento W. LE MOYNE WILLS, M.D.
N. K FOSTER, M.D., Secretary
Sacramento

No. 1

San Francisco ...Sacramento

Chico Los Angeles

HON. J. A. ELSTON, Altorney..

STATE BUREAU OF VITAL STATISTICS.

Oakland

N. K. FOSTER, M.D., State Registrar..Sacramento | GEORGE D. LESLIE, Statistician.

Sacramento

STATE HYGIENIC LABORATORY.

University of California, Berkeley

ARCHIBALD R. WARD, D.V.M., Director..

VITAL STATISTICS FOR JUNE.

Summary For June there were reported 1,994 living births; 2,343 deaths, exclusive of stillbirths; and 2,366 marriages. For an estimated State population of 2,001,193, these figures give the following annual rates: Births, 12.1; deaths, 14.2; and marriages, 14.9. The corresponding rates for May were 11.7, 14.9, and 10.6. The notable rise in the marriage-rate is due to the fact that June is a favorite month for marriages.

The following counties led in. the number of marriages: Los Angeles, 562; San Francisco, 384; Alameda, 310; and Santa Clara, 123. Next in order were Sacramento, 98; Marin, 83; Orange, 76; Fresno, 70; San Diego, 53; and San Bernardino, 52.

The freeholders' charter cities with the highest number of births were: San Francisco, 434; Los Angeles, 354; and Oakland, 203. Next were: Berkeley, 56; Pasadena, 49; Fresno, 36; San Diego, 29; Alameda, 28; and Sacramento, San José, and Stockton, each 26.

The cities with the greatest number of deaths were: San Francisco, 526; Los Angeles, 304; and Oakland, 169. Next in order were: San Diego and Stockton, each 47; San José, 43; Sacramento, 36; Berkeley, 35; San Bernardino, 30; Fresno, 28; Long Beach, 27; Pasadena, 26; and Alameda, 25.

The June deaths were distributed by geographic divisions, as follows: Northern California-coast counties, 85; interior counties, 170; total, 255. Central California-San Francisco, 526; other bay counties, 335; coast counties, 175; interior counties, 352; total, 1,388. Southern California-Los Angeles, 475; other counties, 225; total, 700. State total, 2,343.

Causes of Death. The number of deaths in June was highest, not for tuberculosis, as usual, but for heart disease and allied ailments. There were 349 deaths, or 14.9 per cent of all from diseases of the circulatory system, against 329, or 14.0 per cent, from tuberculosis of the lungs and other organs. Third in order were diseases of the respiratory system, causing 219 deaths, or 9.3 per cent of all. There were 55 deaths from meningitis and 188 from other diseases of the nervous system, apoplexy, etc.

Typhoid fever, as is almost invariably the case, was the most fatal epidemic disease in the month, the per cent of total deaths from this disease being 1.5 for June, against 1.1. for May. The deaths from epidemic diseases in June were as follows: Typhoid fever, 36; diphtheria and croup, 25; measles, 24; whooping-cough, 21; scarlet fever, 12; influenza, 10; malarial fever, 6; and all others, 15.

The following table gives the number of deaths from certain principal causes for June, as well as the proportions from each cause per 1,000 total deaths for both June and May:

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The State Bureau of Vital Statistics furnishes the United States Census Bureau at Washington with a copy of each death certificate filed in its office, and from these the United States Census reports of vital statistics are made out. The efficiency of the California statistics was considered perfect enough to warrant the State being accepted as a registration state, a position attained by only fifteen other states, and they, with the exception of Colorado and South Dakota, all east of the Mississippi River. Two states during the past few years have been dropped from the list of registration states because of their failure to keep up to the standard.

The Census Bureau has been investigating the California returns and find many deaths not reported. The result, if this continues, will be to drop California from the list of registration states, which will be an announcement to the world of the inefficiency of the State to properly do its duty. The duty of making out death certificates is upon the undertakers, and it is a misdemeanor to bury or otherwise dispose of a dead body without properly filling out a certificate and securing from the registrar or sub-registrar a burial permit. This law must be

respected, and whenever a violation is discovered it will be reported to the legal department for prosecution.

MEETING OF STATE BOARD OF HEALTH.

The regular quarterly meeting of the State Board of Health was held in the office of the Secretary in Sacramento on Friday, July 12th..

The main subjects of discussion were, "The education of the people as to the best means of curing and preventing tuberculosis," and "The location of the Pure Food Laboratory and selecting its Director."

The last Legislature appropriated $2,000, which the Board is to use in disseminating knowledge in regard to the best means of preventing and curing tuberculosis. The State is so large, the subject so extensive and important, and the sum so relatively small, that it is difficult to expend it with any very extensive hopes of apparent results.

Maryland requires the registration with the State Board of Health of every case of tuberculosis by the attending physician, and when this is done, furnishes the patient an outfit of spit cups, paper napkins, disinfectants, etc., and full instructions as to care so as not to infect others. The physician is paid $1.50 for reporting and seeing that instructions are properly understood. The law requires that secrecy be maintained, and the officers are not allowed to talk of the cases except among themselves.

Good results are following this method, but it is impossible for the California State Board of Health to follow the plan, for two reasons: First, physicians are loath to obey the State law requiring the reporting of cases of tuberculosis; and second, the cost would be prohibitive with our small appropriation.

The idea of an illustrated lecture delivered throughout the State, with the distribution of short, terse slips of reading matter, was considered with a good deal of favor, and steps are being taken to study its advisability.

The Pure Food and Drug laws passed by the last Legislature are in effect so far as to make it unlawful to manufacture impure food or drugs. The establishment of the laboratory and examination of samples do not, however, go into effect until January 1, 1908, and until that time the same laws, or want of them, exist as before, and we can expect the foam on our soda water to be made from soap bark, and our raspberry jam from apples-we hope nothing worse.

The Board decided to locate the laboratory at the State University laboratory in Berkeley, and appointed Prof. M. E. Jaffa as Director. No assistant has as yet been appointed. It is the object of the Board to do earnest, honest work for the State; to limit as much as possible the production and sale of impure products, and to protect the honest manufacturer and dealer. The appointment of Professor Jaffa, who has a world-wide reputation as an expert food chemist, is a guarantee that the work will be done in an efficient and honest manner, for his reputation for integrity is equal to that for ability.

PLAGUE.

"Oscar Tomie, aged 24, native of Finland, occupation given as a sailor, and employed upon the 'tug 'Wizard,' was taken ill on May 24th and admitted to the U. S. Marine Hospital at San Francisco. On the

evening of May 26th the patient died, and the circumstances surrounding it appearing suspicious, an autopsy was ordered performed by the hospital authorities, at which autopsy Dr. Currie of the Public Health and Marine Hospital Service was present as a witness. A post-mortem diagnosis of bubonic plague was made. On May 27th, the Board of Health was notified of said findings, and, the Chief Sanitary Inspector and Bacteriologist was ordered to investigate. Specimens of tissue were taken from the spleen; cultures were prepared, and pigs inoculated, which after five days, died, and upon autopsy showed the cause to be bubonic plague.

"The history of the patient is indefinite so far as his local residence is concerned. The latter was given as 247 Steuart street, a rooming house known as the Pioneer Hotel, where, three weeks prior to his being admitted to the hospital, he had engaged a room and taken some of his effects thereto; but according to the statement of the proprietor, he had slept but one night in the room during the three weeks. This room was disinfected with sulphur and kept sealed for five days, after which it was opened by an inspector of this department. All dunnage of the patient, as well as all blankets, mattresses, and other movable contents in the room, were destroyed by fire. The walls were then ordered whitewashed and repainted.

"The tug 'Wizard' leaves an erratic history. She left this port about the 4th of May, and made one round trip to Coos Bay, returning to Howard Street Wharf No. 2 on the 12th of May. On the 13th, she left Howard Street Wharf No. 2 and went to Oakland Creek to haul scows, and remained on this work during the 14th, 15th, 16th, 17th, and 18th, returning to Howard Street Wharf No. 2 on the latter day. The period of infection in the case, in all probability, was on either the 16th, 17th, or 18th. During this time the boat was in Oakland Creek, tied up at night at Boole's Wharf. On the night of the 18th, she tied up at Howard Street Wharf No. 2. One point that may have a bearing on the question is in the fact that the Matson Navigation Company's vessel from Honolulu and Hilo tied up at the same wharf.

"Upon obtaining the above information, this department forwarded a request to Dr. W. C. Hobdie, medical officer in command of the San Francisco Quarantine Station at Angel Island, requesting that said tug 'Wizard' be immediately taken charge of on her return to this port and properly disinfected. This, however, was made unnecessary, as on Friday, the 7th inst., the final chapter in the history of the 'Wizard' and her crew terminated.

"On the 29th of May, while towing the barkentine 'Northwest' from San Francisco, the 'Wizard' struck at 2:20 in the afternoon, sinking at 2:30. The crew, twelve in number, escaped to the barkentine 'Northwest'; they remained on board the 'Northwest' until the 5th ult., when, owing to a shortness of provisions, half of the crew, six in number, was transferred to the schooner 'Henry Wilson,' bound to this port with a cargo of lumber. On the morning of the 6th ult., for the same reason, the remaining six members of the crew were transferred to the steamer 'Atlas' bound for Port Harford for oil. On the morning of the 7th ult., at 9 o'clock, the 'Atlas' transferred these six men to the steamer 'City of Puebla,' bound for San Francisco.

"The above data were obtained by Dr. Hobdie from the captains of the respective vessels mentioned. On the morning of the 7th, Dr. Hobdie

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